Medicine & Health
neurophilosophy | February 13, 2008The 3-minute film clip below is definitely not for the squeamish. It comes from a documentary called A Hole in the Head, made in 1998, and shows a Kisi medicine man performing the "operation of the skulls".
neurophilosophy | February 10, 2008Every so often, I get an email from someone who is seeking advice on some medical issue. For example, I received this short message a few days ago:
I just came across your report on Risperdal, and was wondering what your take is on a 3 year old taking Seroquel? How about a dosage of 900 mg per day? My daughter has been on it for almost one year now. Please give me your honest feedback on this.
My honest opinion is that a 2- or 3-year-old child should not be prescribed any kind of antipsychotic. But that's just an opinion, and, I should stress, a non-professional one. I did not study…
neurophilosophy | February 5, 2008The New York Times and Washington Post have stories on the appearance of a mysterious neurological illness in workers at a pig slaughterhouse in the southeastern Minnesota town of Austin.
The condition has been named progressive inflammatory neuropathy (PIN), and has so far been reported in 6 men and 6 women, all of whom complained of burning sensations, weakness and numbness in the limbs. The symptoms developed over periods of between 8 to 213 days, and in some cases progressed to paralysis of the legs. They are likely to be caused by demylination and inflammation of the peripheral nerves…
neurophilosophy | January 30, 2008
Canadian surgeons have made a serendipitous discovery. While using deep brain stimulation to try suppressing the appetite of a morbidly obese patient, they inadvertently evoked in the patient vivid autobiographical memories of an event that had taken place more than 30 years previously. They also found that the electrical stimulation improved the patient's performance on associative memory tasks.
These unexpected findings raise the possibility that deep brain stimulation could be used to treat patients with Alzheimer's Disease, and the research team is now beginning a small clinical…
neurophilosophy | January 24, 2008The operation of Trepan, from Illustrations of the Great Operations of Surgery: Trepan, Hernia, Amputation, Aneurism and Lithotomy, by Charles Bell, 1815. (John Martin Rare Book Room at the University of Iowa's Hardin Library for the Health Sciences.)Trepanation, or trephination (both derived from the Greek word trypanon, meaning "to bore") is perhaps the oldest form of neurosurgery. The procedure, which is called a craniotomy in medical terminology, involves the removal of a piece of bone from the skull, and it has been performed since prehistoric times. The oldest trepanned skull, found at…
neurophilosophy | January 20, 2008The Canadian Globe and Mail reports on the remarkable case of Stacey Gayle, a 25-year-old woman from Edmonton who has just had neurosurgery to treat intractable epilepsy.
Gayle (right) was suffering from musicogenic epilepsy, a rare form of the condition in which seizures are triggered by music. In some patients with this type of epilepsy, listening to any type of music provokes a seizure. In others, seizures are only triggered by certain types of music.
The stimuli which induce seizures in musicogenic epileptics can be even more specific. In one case, the attacks occurred only when he played…
neurophilosophy | January 15, 2008A forthcoming PBS documentary called The Lobotomist examines the career of psychiatrist Walter J. Freeman, who performed nearly 3,000 "ice pick" lobotomies during the late 1930s and 1940s.
The hour-long program, which is partly based on Jack El-Hai's book of the same name, contains old footage of Freeman performing the procedure, and features an interview with Howard Dully, who was lobotomized at the age of 12 (and whose memoir was published last year).
Freeman fiercely advocated - and popularized - the lobotomy. He travelled across the U.S. in his "lobotomobile", teaching others how to…
neurophilosophy | December 17, 2007
Photograph courtesy of the Exploratorium
Jonah Lehrer* points out an exhibition of Paul Ekman's photographs at the Exploratorium in San Francisco.
Ekman is a psychologist at UCSF who has spent time in Papua New Guinea studying the facial expressions of the people there, to try and determine whether or not such expressions are universal, as Darwin suggested in The Expression of Emotion in Man and Animals.
The exhibition in San Francisco consists mainly of Ekman's photos of the South Fore peoples, a subgroup of about 8,000 individuals who live in the highlands to the east of the…
neurophilosophy | November 2, 2007On November 4th, 1906, during a lecture at the 37th Conference of South-West German Psychiatrists in Tubingen, the German neuropathologist and psychiatrist Alois Alzheimer (1864-1915, right) described "eine eigenartige Erkrankung der Hirnrinde" (a peculiar disease of the cerebral cortex). In the lecture, he dicussed "the case of a patient who was kept under close observation during institutionalisation at the Frankfurt Hospital and whose central nervous system had been given to me by director Sioli for further examination". This was the first documented case of the form of dementia that would…
neurophilosophy | October 30, 2007An article about Oliver Sacks, from the current issue of Seed magazine, has just just been made available online.
Author Jonah Lehrer, who met with Sacks to research the article, provides interesting biographical details about the neurologist, including how he started out as a science writer.
In the late 1960s, Sacks carried out a clinical study in which a new drug called L-dopa was used to treat patients with encephalitis-induced Parkinsonian symptoms. The study drew heavy criticism, because the treatment had severe side effects, and the symptoms eventually returned in all of the patients.…
neurophilosophy | October 27, 2007The Guardian reports that the Ministry of Defence has just started a major study into traumatic brain injury (TBI) in British troops returning from Iraq and Afghanistan.
In an accompanying article, the behavioural, cognitive, emotional and physical symptoms of this "silent injury" are described by the father of an American soldier who sustained TBI during a 24-month tour of duty in Iraq.
The official figures on TBI in American troops are based only on cases involving a penetrative head wound, and evidence published earlier this year in the Journal of Neurosurgery suggests that the high…
neurophilosophy | October 19, 2007In Time magazine, orthopaedic surgeon Scott Haig relates his practical experience of an ethical dilemma.
While performing a biopsy, Haig's patient inadvertently finds out her prognosis of cancer. In the operating room is an anaesthesiologist who has a dose of propofol ("milk of amnesia") at the ready.
If you were the anaesthesiologist, would you administer - without consent - the propofol, so that the patient's memories of the last few minutes are erased? For Haig, there is no dilemma.
neurophilosophy | October 8, 2007In The New Yorker, Jerome Groopman discusses the work of Adrian Owen, a researcher at Cambridge University's Cognitive and Brain Sciences Unit who has been using functional imaging to assess patients in a vegetative state.
Neurologists face major problems in diagnosing the persistent vegetative state (PVS) and other "disorders of consciousness" such as the minimally conscious state (MCS), not least because there is no reliable means of assessing the level of consciousness in patients.
Large proportions of patients in such conditions are therefore misdiagnosed, and, until recently, most…
neurophilosophy | October 7, 2007A new study in the British Medical Journal concludes that "there is no strong evidence to associate chronic traumatic brain injury with amateur boxing,"
The authors systematically reviewed 36 observational studies of amateur boxers published over the past 50 years. But they acknowledge that the general quality of the studies is very poor, so, despite the conclusion, their findings are actually inconclusive.
In an accompanying editorial, neurologist and sports physician Paul McRory notes that boxers' careers are much shorter now than they were in the first half of the last century. Boxers…
neurophilosophy | October 3, 2007The Milken Institute, an independent economics think tank, has just released a large study of the burden of chronic disease on the U.S. economy.
The report provides details on the financial impact of 7 diseases (cancers, diabetes, heart disease, hypertension, stroke, mental disorders and pulmonary conditions), in terms of both the cost of treatment and lost productivity.
Figures are provided for individual states and for the country as a whole. The The current trends are extrapolated to provide estimates of the economic impact over the coming decades. The report also details the savings…
neurophilosophy | October 1, 2007
A team of researchers from Yamaguchi University in Japan has submitted a patent application for an implantable brain cooling device that would be used to develop a new treatment for severe cases of epilepsy.
Epilepsy is a condition that is characterised by abnormal electrical activity in the brain. Many epileptics experience seizures, during which they convulse - sometimes violently - before losing consciousness. These seizures are caused by an "electrical storm" of abnormal neuronal activity that spreads from the locus (or point of origin) to adjacent tissue.
The brain cooling device is…
neurophilosophy | October 1, 2007I should have discussed the image that I included in yesterday's post about eugenics. Believe it or not, the scale that is illustrated in that image - with "moron" at the top and "idiot" at the bottom - was used by physicians to aid their diagnoses.
Whether one was a moron, an imbecile (of high-, medium- or low-grade!) or an idiot depended upon one's intelligence quotient (IQ), which was determined using the standardized test that was administered widely in the U.S. following its introduction in the early 20th century.
Anyone who scored an IQ of 70 or lower was considered to be "feeble-minded…
neurophilosophy | September 30, 2007
The word eugenics immediately makes one think of the racial hygiene programs of the Nazis and the experiments performed by Joseph Mengele on those held in the concentration camps, but far fewer are aware that there was a large and powerful eugenics movement in the U.S. during the first half of the 20th century.
For example, by 1941, no less than 33 states endorsed policies for sterilizing "defective"members of society, such as criminals, the "feeble-minded", epileptics, the mentally ill and, of course, blacks (and non-whites in general).
Much of the eugenics research in the U.S. was…
neurophilosophy | September 29, 2007Over the past few days, there have been numerous scary news stories about a "brain-eating" amoeba that has killed six boys and young men this year (three in Florida, two in Texas and one in Arizona, the most recent case being that of 14-year-old Aaron Evans, who died on September 17th).
The amoeba in question is Naegleria folweri, a thermophilic (heat-loving) free-living organism that is commonly found in rivers, fresh water lakes and soil all over the world.
N. fowleri infects humans very rarely, but infection is usually fatal. It normally occurs during water-related activities such as…
neurophilosophy | September 26, 2007In the Annals of Neurology, a team of physicians, led by Tony Ro of the Department of Psychology at Rice University in Houston, Texas, report the unusual case of a woman who began to feel sounds following a stroke
The woman, a 36-year-old professor, suffered a rare type of cerebrovascular accident: a lacunar infarct, in which a small blood vessel deep within the brain became blocked. This led to damage in the ventrolateral thalamic nucleus (VL) on the right side of her brain.
When first examined, some 9 months after her stroke, the woman reported significant changes in her sensations and…